Author: Nimisha Krishnaswamy

6. In Full Swing

Posted on by Nimisha Krishnaswamy

The design studio is filled with a sense of productivity. Prototyping is in full swing, as each team is trying to get their projects done before our final presentations next week. We even had a surprise visit from Kyla and Liseth, who are working on a low-cost, reusable ostomy bag and a cervical cancer thermocoagulation model!! A picture speaks a thousand words, so here are a few that will hopefully give you a sense of what the studio has looked like these days.

Hard at work on our prototypes!

Over the last 2 weeks, each of our teams has been faced with different obstacles: my team realized that the only pulse sensor in the design studio is broken, Alex’s team has been struggling to properly simulate muscle tension with elastic, Hannah’s team had an overnight 3-D print fail (probably due to a power outage at night), and Shadé’s team struggled to acquire the materials they need for their prototype from local markets and stores. It’s been amazing to watch as each team has adapted to these challenges and, in true Malawi fashion, come up with clever ways to improvise and keep moving forward.

Here’s how my team decided to move forward: after we realized that we didn’t have a working pulse sensor in the studio, we decided to spend the time we had left wisely, and really capitalize on the resources that are readily available to us. Since engineering is an iterative process, we decided to design the circuit and write the Arduino code for the pulse rate monitor and leave space in our CAD design for a pulse sensor. We are also going to focus our time on documenting the changes we make and write out an instructions manual to set up the device. This way, the team that works on the next iteration of this device can read our instructions manual and when they have access to a working pulse sensor, they will be able to easily incorporate it into the device using our CAD files, circuit diagram, and Arduino code.

With this decision, we switched gears and started to focus on the armband for our device. In order to make sure the armband was adjustable and comfortable, our team decided to use moldable silicone rubber and designed a 3-D printed mold. Designing the mold, a seemingly straightforward task, ended up being several days of trial and error, but we finally came up with a good design – a two-piece mold that snaps together and is easily openable, with a bar in the middle to create a hole for the temperature probe and pulse sensor wires to pass through.

The final iteration of our clipping-mechanism mold to make the armband

Outside of prototyping, these past 2 weeks have shown me how quickly new communities can be built. I’ve found myself reflecting on my initial reservations about the internship – would I bond with my teammates from Malawi and Tanzania? Would we have anything in common? Would I be able to foster an environment where everyone’s ideas feel not just respected, but celebrated? Fast-forward 6 weeks and my teammates and I talk about everything together – our love for the TV show ‘Friends’, politics in Malawi and the US, how stressed we are about getting a grown-up job in the “real world”, and how much we love the samosas in the Poly cafeteria – all while listening to each other’s favorite music as we work on our project in the design studio. I never would have guessed that in just 6 short weeks, I would have made such special connections with people from all over the world. Before we started this internship, Dr. L would remind us to “expect the unexpected”. I always interpreted it as being prepared for unique challenges during the design process, but I’ve come to realize that this advice applies to building community too.

Here is a short anecdote from my journal that hopefully conveys how strong our community has become in such a short time:

Day 40:

Friday (July 12th) was my birthday and Sunday (July 14th) was Tebogo’s birthday, so this weekend we decided to host a cookout / party back at the lodge and invite all the interns. In preparation, we bought samosas, spring rolls, potatoes to make chips (french fries), hotdogs, sodas, and other snacks – it was enough food to feed an entire army. It took HOURS for us to cook it all, but it was so worth it.  Joel bought a speaker from the market nearby, and we decorated the whole place with balloons. I was so excited when everyone started showing up and we had so much fun sharing stories and playing card games. It was such a perfect day and I really thought it couldn’t get any better. Boy was I wrong. Chisomo showed up with the most BEAUTIFUL cake I have ever seen (apparently he had been pestering Hannah with questions about me…like what my favorite color was, and what flavor cake I like… I had no idea any of this was happening). It really was the sweetest gesture and made this birthday one I will never forget.

As always, here are some bonus pictures from our adventures last weekend!

Group photo from our cookout!
Look how pretty the cake is  😍 Thank you Chisomo!!
On Sunday, we visited the Satemwa Tea Plantation. The tea here is so flavorful, and I bought so much Black tea, Earl Grey, and Green tea to bring back for my parents!

— Nimisha 🙂

 

 

 

 

 

 

 

 

 

 

 

 

5. Let the Prototyping Begin!

Posted on by Nimisha Krishnaswamy

Going into our 4th week of work, all 4 teams have finally begun prototyping. After 3 weeks of extensive needs-finding and research at various hospitals, we are ready to get our hands dirty. And I mean that literally. I leave the studio every day with my hands covered in a layer of solidified hot glue.

Before I get into the details about my project and the progress we made this week, I want to formally introduce my three teammates:

Joel Ngushwai: Dar es Salaam Institute of Technology

Christina Kalulu: The Malawi University – Polytechnic

Boniface Kaseka: Malawi University of Science and Technology

As I mentioned briefly in previous blogs, my team was initially tasked with developing a low-cost continuous temperature monitor for mothers during labor. The project was actually started by a team at Rice University, and now we are taking over from where they left off. The current version of the device uses a thermistor to measure temperature from the axillary artery on the upper arm. It has 3 LED’s (blue for when temperature is too low, green for when the temperature is within a safe range, and red for when the temperature is too high) and a buzzer to alert a nurse when the mother’s temperature is unsafe.

This is what the prototype looked like at the end of last summer! However, the previous team was unable to leave this prototype behind so my team will have to work hard to recreate this prototype and incorporate all our new changes to it.

Before I delve into the details of our prototype plan, I want to talk a little about the need for continuous monitoring devices in countries like Malawi. Over eight million neonates die due to complications during pregnancy and labor per year, and 95% of these deaths take place in low resource and developing areas. Many complications that contribute to these deaths are due to changes in maternal temperature and pulse rate during labor. Intrapartum fever (≥ 38°C) and high pulse rates (≥ 100 bpm) can lead to an increased risk of complications including infections and fetal distress.

After talking to many nurses at Zomba Central Hospital, Queen Elizabeth Central Hospital, and Mulanje District Hospital, my team learned that currently, most hospitals in Malawi use non-invasive thermometers which are often lost or easily broken, and many nurses end up relying on using their hand to check whether a mother has a fever. Additionally, many wards don’t have access to pulse rate monitors, and oftentimes, nurses have to manually count the patient’s pulse rate – which means it is too time consuming to be done regularly. As a result, nurses are typically too busy or overwhelmed and don’t always end up using a partograph to record maternal vitals. In fact, a 2017 study in Malawi found that on average, 65.3% of partographs lacked temperature recordings.

A typical partograph used to monitor vitals during labor and delivery

These findings confirmed the need for a continuous and accurate vital signs monitoring device that can assist nurses in monitoring and recording the incidence of maternal fever and high pulse rate during labor.

With guidance from Francis Masi (who mentored the team working on this project last summer), my team has decided to make the following changes to the existing prototype:

  1. Include a circuit for pulse rate detection
  2. Transition from 4-Digit 7-Segment display to an I2C LCD or TFT LCD display
  3. Include a bluetooth or WiFi module to allow patient information to be stored on the device (so that nurses can access past data and view trends of temperature changes)
  4. Transition from a cloth armband to one that is more easily cleaned, adjustable, and comfortable
  5. Include battery life indicators

My team is slowly starting to formulate our project idea into a reality. This week we began recreating and troubleshooting the device’s temperature circuit using a thermistor, a basic I2C LCD Display, and 3 LEDs as a visual alert system. We also began designing the control unit (which will ultimately be 3-D printed) on SolidWorks.

Status update: We started the week getting really weird temperature readings with our circuit (I’m pretty sure an ambient temperature of 40 degrees celcius is not typical of Malawi winters…), but by the end of the week we finally managed to get an accurate temperature reading and display it on the LCD!

It is absolutely crazy to think that we are over halfway done with our time in Malawi. In 4 and a half short weeks, I have grown to love this country and its people. I love waking up to the beautiful sunrise over the mountains that Kabula Lodge overlooks. I love cramming over 20 excited and passionate young engineering and medical students (onto a bus meant for 14 people) every morning to Queens. I love working with my team at the Poly Design Studio, eating lunch at LJ’s (a small red shack by Queens, which we have, rather appropriately, nicknamed “red shack”). I love family dinners back at Kabula with all the Rice and DIT interns. I love everything here and I’m determined to make the most of every day we have left.

***bonus content***

This weekend we finally attempted the long-overdue 3-day hike up Mount Mulanje! It was so hard that many of us found ourselves joking about how we might die before we make it to the top. Here are some pictures as proof that we made it out alive!!

— Nimisha 🙂

 

4. Learning in Lilongwe

Posted on by Nimisha Krishnaswamy

This week all 19 summer interns (16 from Poly Design Studio + 3 from Queens CPAP Office) piled onto a bus and travelled 5 hours to Lilongwe, the capital city of Malawi. The streets of Lilongwe, just like Blantyre, were lined with bustling markets selling everything from fresh fruits and vegetables to colorful chitenge cloths. As soon as we arrived, we checked in to the Bridgeview Hotel and rested in preparation for a busy day…

The main purpose of our visit was to attend the Malawi Technology Innovation Pitch Competition on June 27th, but since the competition was in the evening we were able to squeeze in a visit to Physical Assets Management (PAM) at Kamuzu Central Hospital. We were greeted by Mr. Pius Chalamanda, an incredibly dedicated medical engineer at PAM, who was nice enough to answer all our questions for 2 whole hours AND give us a walking tour of PAM so we could learn about the challenges they face with maintaining and repairing broken medical equipment. I got to ask a lot of questions about patient monitors (which was useful for both the projects I am working on – a Maternal Monitoring Device here at the Polytechnic and a Neonatal Temperature Monitor for Kangaroo Mother Care back at Rice). One of the main issues with patient monitors, I learned, is the probes – SpO2 probes, temperature probes, ECG probes. They are super fragile and break easily even when handled carefully. Up until now, I was only aware of the infamous battery problems in almost all patient monitors. I’ve been so focused on ways to make our device rechargeable, that the probes never even crossed my mind. This new information about the fragility of probes definitely provides a new angle to pay attention to as I continue working on both of my projects.

A whole section in PAM dedicated to broken patient monitors

Overall, I learned that the challenges faced in PAM can be summarized into 5 main categories:

  1. Understaffing
  2. Spare parts and consumables are difficult to procure
  3. Lack of diagnostic tools (to test the functionality of medical equipment) and servicing tools (to fix broken medical equipment)
  4. Language barrier (when trying to install / service donated equipment whose manuals are often in different languages)
  5. DUST and MOISTURE significantly reduce the lifespan of nearly all medical equipment

The visit was enlightening and everyone we met at PAM was so dedicated and hardworking. Hearing them talk about all these challenges made me realize the importance of creating medical devices that are durable, sustainable, and easy to repair (paying special attention to ensure that spare parts/consumables are locally available). Although many of these challenges initially seemed difficult to tackle because of financial constraints, I left PAM with my mind full of ideas for new projects that Rice 360 could take on to help make the maintenance and repair of medical devices a much more efficient process.

Later that evening we dressed ourselves up in business casual and headed to the Pitch Competition hosted by mHub, an innovation space in Lilongwe. The competition consisted of 10 teams of student engineers in Malawi presenting exciting innovative technologies in a short 3-minute pitch. One team presented a voice-to-text application for sign language in order to bridge the communication gap between people who can and can’t hear. Another team presented a low-cost, solar-powered water filtration device that used UV light to eliminate bacteria. My personal favorite was a low-cost cold chain box to transport blood vaccines and diagnostic samples from rural areas in Malawi to central hospitals. The team that presented this device has already sent a prototype to FIND, a non-profit in Geneva specializing in diagnostic tools for low-resource settings. I’m so excited to see where they go from here!!

Dr. Richards-Kortum giving the opening remarks at the Pitch Competition

After the presentations, we got the chance to mingle with the student teams and it was so amazing and humbling to be among some of the most talented student engineers and in Malawi. I got to talk to donors from the Lemelson Foundation and partners of NEST 360 about both of my current projects and it was all so exciting. We also got to catch up with Dr. Richards-Kortum, Dr. Oden, Georgia, and Raj from Rice 360! 🙂

The whole night felt kind of magical. It reminded me how grateful I am to be a part of this global health community. I distinctly remember looking around the room and feeling inspired, realizing that each one of us comes from a totally unique background: there were people from the US, the UK, Tanzania, Malawi, India. We’ve all grown up with different experiences and have been exposed to different standards of health care, but one thing brought us all together: our passion for improving health outcomes across the globe, our passion for helping people across the globe. Now more than ever, I’m certain that this is what I want to do with my life.

As always, here are some bonus pictures! This weekend, we hiked Zomba Plateau (it was around 3 hours, so just a casual warm up for when we finally hike Mount Mulanje! 😉 )

Flat tire on our drive back from Lilongwe 🙁
Group photo during our hike at Zomba Plateau this weekend
Waterfall at Zomba Plateau! It was so beautiful but the water was literally ice cold (not cold enough to stop us from trying to swim though)

— Nimisha 🙂

 

3. The Future is Female

Posted on by Nimisha Krishnaswamy

As I am writing this blog post, it is June 23rd a.k.a International Women in Engineering Day!!!! To honor this day and simultaneously reflect on the week that just passed, I want to talk about women. Women in engineering. Women in education. Women in Malawi. Women in the United States. Women who have mentored, encouraged, and inspired me as I pursue a degree with not nearly enough female representation.

On the surface, most of our week revolved around brainstorming new ideas for our main projects (my team’s project is a continuous maternal temperature monitor, which we are now planning to update to be a temperature + pulse rate monitor) and finalizing our solution to begin prototyping in the coming weeks. However, after some reflection, I also noticed that many of last week’s events had an underlying running theme: women’s empowerment.

It first started when Dr. Veronica Leautaud (our Rice 360 mom, who we lovingly refer to as Dr. L), the Rice 360 Director of Education, flew in from Rice and came to visit us at the Poly design studio on Wednesday. Dr. L is one of those people that immediately embraces everyone with open arms, and makes you believe you can achieve anything you set your mind to. She has a powerful presence. At the poly, each team got to pitch our final solutions to her in a short 3-minute presentation and hear her thoughts. She was able to give each team real, constructive feedback while remaining unwavering in her support for our ideas, no matter how far-fetched they might have been. She reminded me that being a woman in engineering means more than just demonstrating technical expertise; it means lifting people up through love and positivity.

All the interns with Dr. L when she visited the Poly!

Later that day, I got to watch as Karen Turney, the Rice 360 Director of Development, filled the design studio with a sense of excitement and curiosity. Karen is energetic and encouraging, but most importantly she has a seemingly insatiable curiosity and is an expert at getting anyone to open up about their passions and life goals. I couldn’t help but watch in wonder as she made her way across the room, talking to every single intern in the studio, asking them questions about everything: from family life to hobbies to long-term goals. She makes everyone feel important, like we all have our very own unique story to share with the world. And although she is not an engineer, she reminded me that being a woman in engineering means being unafraid to ask the “silly” questions and taking the time to learn from and grow with your peers.

On Friday, Mrs. Juliana Nyasulu Masi, a lecturer at the Poly, brought in around 20 bright-eyed 1st year students (1st year = 9th grade in the US) to the design studio. While the students walked around excitedly watching interns use 3-D printers, laser cutters, and Arduino circuits, I got the chance to talk to Juliana about her experience being a female lecturer at the Poly. I only spoke to her for a few minutes, but it was enough time to see just how passionate she was, not only about her subject (she teaches C++ at the Poly), but also about inspiring and recruiting the next generation of engineers. I didn’t get the chance to ask for exact numbers, but I’m almost certain she was one of very few women graduating with her degree, and one of even fewer women lecturing a programming course at the Poly. She reminded me that being a woman in engineering means paving the way, not just for yourself, but for all young girls who dream of being an engineer when they grow up.

1st year students visiting the design studio (everyone was so excited to watch the laser cutter do it’s magic!!)

On Saturday, my amazing teammate Christina invited all the interns to a Biomedical Engineering Student Society (BESS) event that she helped organize. Christina, a Biomedical Engineering student at the Poly, is the Diploma Representative of BESS. The event was a great success: it had project presentations from current Biomedical Engineering students, a fun and interactive engineering-themed quiz competition, and an awards ceremony for the best performing students – all tied together by a talented DJ who periodically mixed music to keep the room entertained. As I looked around, I quickly noticed that I could count the number of women in the room on my two hands. Still, it was so humbling to be surrounded by so much talent (including the first ever graduating class of Biomedical Engineers at the Poly!!). Christina, the only woman on the BESS board of representatives, managed the event with so much grace and confidence. She reminded me that being a woman in engineering means being unapologetically confident in yourself and not shying away from the spotlight.

My teammate Christina speaking at the BESS event she helped organize

Finally, I want to thank my fellow interns, the people who I have already learned so much from and who continue to inspire me every single day. Of the 7 Rice interns, 6 of us are girls. We are still learning what it means to be women in engineering and other healthcare-related industries, and how we can speak up to support other women trying to enter similar fields. They remind me that being a woman in engineering means learning through trial & error and taking your time to find your place and your voice.

As a woman in engineering, I’ve always been aware of how lucky I am to be surrounded by powerful, intelligent women who inspire me to follow my dreams. I’ve also always been aware of the odds against me. The odds against all the women around me. If there’s one thing that this week reminded me, it’s this: I’m here, in Malawi, working on meaningful and impactful engineering projects, and I’m going to defy the odds.

***completely unrelated bonus content***

Continuing our tradition of eating icecream at Mikos for lunch every Friday. Special shoutout to Alex (he may not be a woman in engineering, but we love him regardless!!)
 All the Rice + DIT interns after our safari this weekend at the Majete Wildlife Reserve

 

 

 

 

 

 

 

 

 

 

 

 

 

— Nimisha 🙂

 

2. Looking Closer

Posted on by Nimisha Krishnaswamy

Going into our first week of work, I felt excited and a little nervous for what was to come. I wasn’t sure how the technologies we brought over from Rice would be received or what to expect from the hospital visits. I wasn’t sure I would like the food (I’m usually a pretty picky eater) or if I would click with the Malawi interns in the same way that I have with the Tanzania interns. So many questions but not much time to worry about them…

June 10th, Monday – Anything is possible!

Our first day at the Poly began with a warm welcome from the Polytechnic’s Dean of Engineering and a few presentations on the engineering design process and human-centered design. We also had mini brainstorming session: we had to write down as many uses we could think of for bricks. After a minute of frantically scribbling down uses, we shared our ideas with everyone. Some of my favorites were “a giant game of Jenga” and “a SUPER effective paperweight”. This small activity reminded me why I love engineering so much. No idea is a bad idea. Anything is possible!! I’m going to try my best to carry this mindset with me as we start brainstorming for our main projects.

Later in the day we each presented the technologies that we brought from Rice to the rest of the interns and administration at the Poly and it was so nice to hear everyone’s thoughts and feedback on our projects. We ended the day with a design challenge where each team had 2 hours to create a contraption that would allow a ping pong ball to fall to the floor from a height of 1m in no more than and no less than 30 seconds. My team tried to make a kind of maze that the ball could fall through for 30 seconds before hitting the ground. Ultimately our ball fell in 5 seconds, but I think we deserve an A for effort. It was really good to get our ~creative juices~ flowing and get to know some of the other interns.

All the Rice + DIT + Poly + MUST interns ready to start work!

June 11th, Tuesday – Learning

Tuesday was dedicated to refreshing our knowledge on essential engineering design skills like Arduino, SolidWorks, 3-D printing, and laser cutting. Since I was already familiar with the basics of Arduino and laser cutting, I spent most of my time learning how to CAD on SolidWorks from Hillary (our internship coordinator at Poly). Our mini-project was to design and assemble a functional syringe. I’m so excited to see how all these new skills will translate into prototyping when we start work on our main projects.

The outer and inner parts of the syringe I designed on SolidWorks

Later that day, Hillary sent us our team and project assignments so we could begin preparing for hospital visits. I’ll be working on a continuous maternal temperature monitoring device with Joel (DIT), Boniface (MUST), and Christina (Poly).

June 12th, Wednesday & June 13th, Thursday – Hospital Visits

Wednesday and Thursday were probably the most eye-opening days of this week, and the inspiration for this blog’s title – Looking Closer. We went to Mulanje District Hospital and Zomba Central Hospital where we visited the nursery, high-risk ward, kangaroo ward, labor ward, and Physical Assets Management. The nurses we talked to were so experienced and knowledgeable, and their dedication is so admirable. It was amazing to see the things they achieve with the limited resources they have. Getting to actually walk in to the different wards, I started to look closer at all the ways nurses “improvise” when they don’t have something you might easily find in a high-resource hospital. One sight that stuck out to me in particular was a make-shift wheelchair made using a common plastic chair and some wheels tied on with rope. The high-risk ward was a small, hot room (the whole room is kept at a high temperature for the premature, hypothermic babies since there are no incubators in use) with radiant warmers lined up against one wall. Each warmer (meant for 1 baby) fit 2-3 babies and had a single patient monitoring system with a temperature probe, which meant all 3 babies could not be monitored at once. Still, the nurses did everything they could to make sure all the babies got the attention they needed. Through all my observations, it was clear that there is no lack of creativity, dedication, or intelligence in these hospitals, simply a lack of resources.

Broken Multi-Parameter Patient Monitor, my team hopes to create an affordable, wearable version of this device.

Listed below are some of my main takeaways from both visits:

  1. Lack of nurses – Often times, the neonatal ward has around 20-30 babies but only 3-4 nurses. The labor wards get approximately 20 deliveries per day, but only 2-3 nurses to look after the mothers. Because of this, nurses are usually more preoccupied caring for the large number of high-risk premature babies being born and mothers may end up going unmonitored for certain periods of time.
  2. Thermometers are limited and break often – The labor wards usually have only a couple of thermometers to monitor all the mothers’ temperatures regularly. In Zomba, the labor ward had NO thermometers. This left nurses relying on using their hands to check whether a mother has a fever. There is definitely a need for continuous monitors to help nurses quickly monitor all patients.
  3. Donated devices aren’t always useful – most of the devices we saw (incubators, oxygen concentrators, suction machines, etc.) were either broken or not being used. Donations come from many different manufacturers, often without manuals, and nurses don’t have the time to learn to use these new devices from scratch. Instead, nurses become comfortable relying on their experience and intuition and their clever “improvisations”.
  4. Hospitals are focusing on educational material – In both hospitals, the hallways were decorated with colorful signs and depictions to educate people about things like the importance of STI testing and breastfeeding. I found this to be an interesting contrast to the clinical white walls in most American hospitals.
Broken oxygen concentrators, suction machines, radiant warmers, patient monitors, and ultrasound machines in Physical Assets Management a.k.a the “equipment graveyard”

As a bonus, on the way out of Mulanje District Hospital, we got to see Mount Mulanje and it was so tall that the peak hid from our view behind clouds. Shadé, Alex, Liseth and I are determined to climb it – hopefully we can convince the others to come with us!

June 14th, Friday – Common Ground

On Friday we worked with our teams to compile all our findings from the hospital visits and give a short presentation to the rest of the interns and staff about what we learned. This was the first time I got to work with my whole team, and we had so much fun getting to know each other while also being productive! We ended up talking about the similarities between South African weddings and Indian weddings and it reminded me that although we all come from different places, there is so much we have in common.

June 15th, Saturday & June 16th, Sunday – Good Food and Good Company

This weekend we visited a local market to put our bargaining skills to the test (we weren’t very successful…), cooked some good meals, and spent quality time watching the latest episodes of Black Mirror together.

Trying Nsima (staple food in Malawi) at Pamudzi, an authentic Malawian restaurant. Everything tasted so good!

Ending the week, all my initial worries have vanished. Our technologies from Rice were received well, the hospital visits were educational and inspiring, and I love the food here. I’m already starting to get to know my team and we are beginning to form a good team dynamic to start working on our project. Get ready for some serious brainstorming sessions next week!!

— Nimisha 🙂

1. Adventure Awaits!

Posted on by Nimisha Krishnaswamy

Our long-awaited journey finally began on June 3. We arrived at the Houston airport with 11 large suitcases, ready to take on the 3-day journey. Our first flight took us from Houston to London, where we had an 11-hour layover. After sitting in the same seat for 10 hours, we were all eager to step out and explore the city. It was really exciting to take the underground to all the iconic sites I had previously only heard of from playing Monopoly. We saw Trafalgar Square, Westminster Abbey, the Buckingham Palace, the Big Ben (under renovation 🙁 ), and the London eye!

The five of us in Trafalgar Square during our layover in London!

After stopping at a local pub for some fish and chips, we excitedly hurried over to see Platform 9 ¾ at Kings Cross Station before heading back to the airport.

The next two flights (London to Johannesburg and Johannesburg to Lilongwe) went by pretty quickly. Despite some delays with our aircraft to Lilongwe, we landed smoothly in Lilongwe on the evening of June 5 and were immediately greeted by the lovely and friendly Mr. Richard. He helped us load all our luggage onto a bus and we drove into town to pick up the 4 interns from Tanzania who arrived earlier in the morning. Because of the delays, we decided to spend the night in a hotel in Lilongwe – I finally got to take a warm shower and sleep in an actual bed, so I wasn’t complaining. It was also really nice to get to know the Tanzania interns a little bit over dinner!

We woke up bright and early the next morning to buy new phones and then continue our journey from Lilongwe to the Kabula Lodge in Blantyre. We drove past beautiful mountains, busy markets, and people cooking delicious street food (I saw a lot of donuts that looked really good. Also rats. Didn’t look as good as the donuts…). I couldn’t help but smile because the scenery reminded me so much of my home in India. Exciting fun fact courtesy Mr. Richard: as we were driving, Malawi was directly on our right and Mozambique was on our left!

We checked in to the Kabula Lodge, where we, along with the Tanzania interns, will be staying for the next 2 months, and then headed to town to grab dinner. I was so exhausted, so I went straight to bed when we got back. Here’s a picture of me feeling very proud of myself after struggling for about 20 minutes to get inside my mosquito net.

Me, after finally managing to get inside my mosquito net

On Friday, we decided to take the Kabula Lodge shuttle to Queen Elizabeth to introduce ourselves to everyone in the Rice 360 office. It took us a while to find the office, but once we did everyone was so welcoming! I’m sure Kyla, Liseth, and Sally are going to have a great time working here. We also visited the Poly, which is about a 10 minute walk from Queens, and introduced ourselves to everyone in the design studio. The studio had pretty much everything that the OEDK at Rice has, and I’m so excited to start work there on Monday! We got to meet all of the Malawi interns (from Poly and MUST) and they were nice enough to give us a walking tour of the Poly and take us to the nearest grocery store so we could get ingredients for our *drumroll* VERY FIRST HOME COOKED MEAL in Malawi!! They were all so friendly and gave us so many tips and tricks about how to get around in Malawi. I can’t wait to continue getting to know them over the next 2 months.

Fast-forward to the end of the weekend and we are all slowly starting to adjust to our surroundings and this new pace of life. I know where the nearest restaurants are, where to get groceries, and where to go to withdraw money. Every morning we have tea and toast on the patio and the view behind us is literally picture perfect. I honestly think Windows should use it as their next screen saver.

Next Windows Screen Saver™

We have attempted home cooked meals, mostly just pasta and rice (my mom would be so proud). We explored the town around us: we went to the nearest mall and to a really cute art café called Kwa Haraba. They have poetry readings every Wednesday evening so we will definitely be going back. My favorite part was getting to visit the Museum of Malawi. I learned so much more about the history of this beautiful country. We have spent time at the lodge getting to know the Tanzania interns and it’s so fun talking about the similarities and differences between our cultures! We taught them some card games and they introduced us to popular African music. We’re going to have so much fun living together and learning from each other.

 

Eating lunch at Pizza Inn in the nearby mall
Alex learning how to do laundry by hand

 

 

 

 

 

 

 

 

On Monday we are going to be starting our first official day of work! I’m both nervous and excited to start visiting hospitals and start working on our projects. The next 7 weeks are going to be fun and challenging all at once and I can’t wait to get started. Adventure awaits!!!!

— Nimisha 🙂

0.5: #Goals

Posted on by Nimisha Krishnaswamy

I’ve traveled internationally many times – I’m from India so going home and coming back to Rice always involves long flights and seemingly longer immigration lines. The thought of having to travel for 2 whole days until we land in Malawi is not too daunting. I’m more nervous about what comes after  we land. After 12 years of growing up in Bangalore, India, I can confidently say I am pretty familiar with the ~organized chaos~ of a developing country. But I grew up in a big city. Twelve MILLION people big. I’m not sure how Blantyre, Malawi (population 600,000) will compare. In fact, the only thing I am sure of is that the next two months are going to be different from anything I’ve ever experienced before. Another thing I’m sure of: I will take every new experience in my stride and I am extremely excited for the adventure I am about to embark on.

I’ve spent the last 2 weeks relaxing, and exploring Austin, TX with my sister and some friends. All the downtime got me thinking about my goals for this internship and for my own personal growth.

Internship Goals

  1. Introduce current Rice 360˚ technologies – We will be taking 8 different technologies (listed in my previous blog post) that have been worked on by student teams at Rice. I am eager to see how these devices could work in the setting they were made for. I hope that we will receive meaningful feedback and recommendations for future improvements, and that we will be able to better understand the special circumstances of low-resource hospitals that our devices need to cater to in order to be effective.
  2. Perform Needs Finding – The opportunity to experience and observe hospitals in Malawi first-hand is extremely unique. I hope to capitalize on this opportunity, and scope out five new potential Rice 360˚ projects that future student teams can begin work on. I will be conducting interviews and observing day-to-day activities in order to gain a deeper understanding of the gaps in healthcare that we, as Rice students, can help to address.
  3. Set up MUST Studio – An exciting, new task for the Malawi interns this year is to lead the set-up of a design kitchen at the Malawi University of Science and Technology (MUST), similar to Rice’s OEDK. We are taking 7 suitcases filled with electronics: 3D printers, circuit components, breadboards, etc. We also designed posters with safety guidelines and instructions on how to safely and respectfully use the design space.
  4. Work on assigned on-site project – When we arrive to work at the Malawi Polytechnic (the Poly), we will be split into four teams, each with one Rice intern, one Tanzania intern, and 2 Malawi interns. We will be assigned a project to work on for the duration of our time at the Poly. We will also be participating in a pitch competition in Lilongwe, so I’m super excited to get started!
  5. Work on personal project – While we are there, I will have the opportunity to build a project around anything that sparks my interest! While I am an engineering student and am always eager to work on hands-on electrical and mechanical projects, I would also like to learn more about current educational barriers, training issues, and policy issues that affect the standard of care in Malawi and hopefully find a cool project to adopt for my two months there (and maybe even bring back to Rice to work on during the year)!

Personal Goals

  1. Ask questions – These 2 months will surely provide many opportunities for me to ask questions. I am eager to learn about the standard of care in Queen Elizabeth Central Hospital (QECH) and the other district hospitals. I am adopting a beginner’s mindset, and I am ready to learn from the nurses, staff, and my fellow interns from Malawi and Tanzania.
  2. Build confidence – This summer I will be working on many different projects and I want to focus on building my own confidence in my ability to implement these projects successfully. I am confident that I will pick up new skills quickly and learn from my mentors and fellow interns. I am ready to throw myself into the unfamiliar and make the most of any challenges I face along the way.
  3. Get creative – One of the most important (and fun) parts of engineering is brainstorming creative solutions. The hospital environment in Blantyre will be very different from what I am used to seeing in the US and India. One of the most important things I learned during my GLHT 360 class is the importance of coming up with simple solutions that are easy for nurses to understand, and easy for technicians to troubleshoot if things go wrong. It doesn’t matter how fancy a device looks – if the nurses and technicians don’t know how to use it, it probably won’t be much help. Sometimes the best solutions are right under our noses!
  4. “Lead gently” – Dr. Leautaud used this phrase a lot during our orientation for this internship. Although I am very excited for the opportunity to help serve a community, I can only be here for 2 months. In order to create more sustainable and valuable change, I believe that it is really important to focus on empowering the members of this community to lead their own change.
  5. Have fun! – Getting to spend 2 whole months in a completely new culture and environment is the experience of a lifetime. I am excited to immerse myself in a new culture, establish meaningful friendships with the people I meet, and make memories!

I can’t wait for us to finally leave for Malawi. Here’s a picture of us at the airport with 11 suitcases, ready to take on a 40 hour journey!

— Nimisha 🙂

0: Preparing for Takeoff

Posted on by Nimisha Krishnaswamy

The last couple of months have been busy with preparations. We have attended multiple orientation sessions, signed documents for our program coordinators, booked flights, made appointments to get vaccinations, and started preparing different technologies to take with us to Malawi to get feedback on. I don’t think our to-do list will be getting shorter any time soon, but with the school year ending I’m glad to have so many things keeping me occupied and excited for the summer.

In less than a month, Alex, Hannah, Kyla, Liseth, Sally, Shadé, and I will all be stepping out of a plane and setting foot in the warm heart of Africa: Blantyre, Malawi. The nerves haven’t really kicked in for me yet, I just feel so full of gratitude and excitement for this amazing opportunity and I can’t wait for us to begin our adventures in Malawi.

Right now, we are all working hard in Rice’s Oshman Engineering Design Kitchen (OEDK) to make sure all our technologies are ready in time for us to travel. It’s been really fun and we’re all so surprised at how much we are learning so quickly. In the last week alone, I’ve learned how to use Adobe Illustrator, use a 3-D printer, use a laser cutter, design Printed Circuit Boards (PCB), and use a PCB milling machine. Of course, I still have a lot to learn, but getting to work hands-on on these projects has been so rewarding and soon we will have 8 different technologies ready to take with us:

  1. Mechanism to Lock IV Drip Rate
  2. Reusable Phototherapy Masks
  3. Automatic Bleach Sterilization Equipment
  4. Cervical Cancer Thermocoagulation Model
  5. Neonatal Temperature Monitor For Kangaroo Mother Care
  6. Low-Cost Oxygen Concentration Monitor
  7. Low-Cost, Reusable Ostomy Bags
  8. Ballard Score Gestational Age Training Model

Since there are 7 interns and 8 projects, we decided to split up the work among ourselves. I am in charge of the Neonatal Temperature Monitor for Kangaroo Mother Care. I actually started working on this project during the spring semester in my GLHT 360 class, so I’m pretty attached and super excited to get to take it to Malawi for feedback this summer.

Kangaroo Mother Care to treat hypothermia

Usually, in developed nations like the United States, hypothermic babies can be treated quite easily and effectively with incubators. However, in low-resource countries like Malawi, incubators are often too expensive and too difficult to maintain. Instead, a much more cost-effective practice known as Kangaroo Mother Care (KMC) is used to treat hypothermia. As shown in the photo on the left, KMC is when the mother wraps her baby to her chest with a cloth, known as a chitenge in Malawi, in order to keep the baby warm. With the baby being in close proximity to the mother, the mother’s body warmth is able to regulate the baby’s temperature. It’s pretty effective in keeping the baby at a safe temperature, but it is still really important to have an accurate and continuous monitor that can keep track of the baby’s temperature while KMC is being performed.

 

First prototype: control unit and arm band worn by mother during KMC

The main purpose of our device is to continuously monitor the temperature of neonates, who may be premature and hypothermic, and promptly alert mothers and nurses when the baby’s temperature is too low. All this, while also being small and portable so that the mother can comfortably wear the device on her during KMC. To accomplish this, we designed a device with a control unit that has 3 LED indicators to alert mothers and nurses (blue if the temperature is too low, red if the temperature is too high, and green if the temperature is safe). The control unit also has a vibrational motor inside it which will vibrate, much like a mobile phone, to alert mothers and nurses when the baby’s temperature is either too low or too high. Finally, the control unit has a display screen to show the numeric value of the baby’s temperature. This control unit is placed in a pouch on an arm band that can be worn on the mother’s upper arm. The baby will wear a small, elastic belt around their abdomen, with a temperature probe attached that touches their skin to measure their core temperature. This temperature probe is plugged in to the control unit to continuously display the baby’s temperature reading.

 

Over the next few weeks, we will be finishing up all our prototypes, packing them in suitcases, and praying that they reach Malawi in one piece *fingers crossed*. Some of us are also going to Passport Health soon to get our yellow fever and typhoid vaccinations together, yay for bonding but hopefully I don’t pass out… I’ll keep you updated. I’ll probably be spending a lot of time trying to learn some common phrases in Chichewa (the local language), and watching YouTube tutorials + reading WikiHow posts on how to do grown-up things like washing my clothes by hand and cooking for myself for a whole summer. I can already tell this summer is going to be full of new experiences, and I’m so excited to share everything I learn with you. Next stop –> Malawi!!

— Nimisha 🙂